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Time course of proadrenomedullin in the early phase of septic shock. A comparative study with other proinflammatory proteins.
MedLine Citation:
PMID:  22801438     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIM: It has been shown that pro-adrenomedullin is a good marker of the severity of septic shock but there are no data on the early changes in serum pro-adrenomedullin concentrations in patients with shock.
METHODS: Twenty-one patients with septic shock and 21 healthy subjects studied as controls. Serum concentrations of pro-adrenomedullin, procalcitonin, ferritin, CRP and IL-6 were determined in all subjects at the initial observation. Patients with septic shock were also studied after 24 and 48 hours.
RESULTS: The concentrations of the acute phase proteins were significantly higher in patients with septic shock than in the control subjects during the entire study period (P<0.001). Only procalcitonin significantly decreased on the third day of observation with respect to both the first day (P=0.002) and the second day (P=0.006). Proadrenomedullin (P=0.017) and IL-6 (P=0.001) showed an AUC significantly different from the null hypothesis in differentiating the patients who survived and those who did not. The sensitivity and specificity of pro-adrenomedullin in the assessment of death were 71.4% and 72.7%, respectively, while IL-6 had a sensitivity of 92.9% and a specificity of 60.6%.
CONCLUSION: Proadrenomedullin is a reliable prognostic marker in patients with shock; further studies on a more consistent number of septic patients will definitively assess whether proadrenomedullin may replace the current prognostic markers in critically ill patients with shock due to sepsis.
Authors:
R Pezzilli; A Barassi; A Pigna; A M Morselli-Labate; A Imbrogno; D Fabbri; G Di Nino; R Corinaldesi; G Melzi D'Eril
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Panminerva medica     Volume:  54     ISSN:  1827-1898     ISO Abbreviation:  Panminerva Med     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-07-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421110     Medline TA:  Panminerva Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  211-7     Citation Subset:  IM    
Affiliation:
Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna - raffaele.pezzilli@aosp.bo.it.
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